In patients with a complete blockage in the heart’s arteries that persists over time, treatment with medications alone was found to be equal to percutaneous coronary intervention (PCI), a procedure to open blocked arteries, in terms of major adverse events over three years, according to a study presented at the American College of Cardiology’s 66th Annual Scientific Session.
Overall, about 20 percent of patients died or experienced a non-fatal heart attack, stroke or subsequent revascularization procedure (such as PCI or bypass surgery)–which together comprised the trial’s composite primary endpoint–within three years after enrolling in the study. That proportion was not significantly different for patients randomly assigned to receive PCI compared with those assigned to receive only drugs, which included aspirin, a beta-blocker, a calcium channel blocker and a statin.
The findings are in line with evidence from previous studies suggesting that PCI does not improve long-term patient outcomes compared with medications alone in patients with coronary heart disease (buildup of plaque in the heart’s arteries, the most common form of heart disease) who have not experienced a sudden change in symptoms. This is the first study to compare clinical outcomes from the two treatment approaches in patients with a complete or near-complete blockage in the heart’s arteries that persists over time, known as chronic total occlusion. Chronic total occlusion occurs in about a quarter of people with coronary heart disease and can cause chest pain, fatigue, shortness of breath and ischemia (damage that results when tissues are deprived of oxygen).
“PCI is not the only solution to treat chronic total occlusion, and in terms of patient outcomes, cost versus benefit, and other considerations, it is not beneficial to use PCI for all chronic total occlusion lesions,” said Seung-Jung Park, MD, a cardiologist at Asan Medical Center in Seoul, South…